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MAR-02-2004 13:17 FROWALL CAL INS <br />9167640158 T-229 P 001/002 F-106 <br />tDATE(MMIDGm' <br />OF <br />LIABILITY INSURANCE <br />yi <br />12, 17/2DC3 <br />CERTIFICATE <br />CATE IS ISSUED AS A MATTER OF INFORMATION <br />16) 784-9070 <br />CONFERS NO RIGHTS UPON THE CERTIFICATE <br />DOES NOT AMEND, EXTEND OR <br />nsurance Agency <br />ff—A�o <br />IS CERTIFICATE <br />AFFORDEq BY THE <br />POLICIES BELOW. <br />sifle Ave. Ste. #l05OVERAGE <br />aURR <br />7F+RI.Y OA ?IINA <br />ORgING COVERAGENAICit <br />CA 95678— <br />rofita Ina Alliance <br />wSURF- <br />. VIETNAb03SE C TNTTY OF OPANGE COUNTY <br />INSURERB: CAROLINA CASUALTY <br />-� <br />WsuREROFIDELITY b DEPOSIT CO. <br />1618 W. FIRST STREET <br />INSURER b <br />SANTA ANA CA 92703- <br />INsuRER E: <br />MAY PERTAIN. THSTANDING <br />COVERAGES NAMED ABOVE FOR THE POLICY <br />INSU IIC MAY ISSUED <br />_D <br />REOU REMENT TERM OR CONDITION F AM' CONTRACFL T OR OTHER DOCUMENTEWITT RESPECT TO RMS. THIS USII N AND I SUCKR <br />HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES, <br />.' <br />THE INSURANCE AFFORDED SY THE POLICIES DESCRIBED <br />HAVE BEEN REDUCED BY PAIq CLAIMS- - <br />EXPIRA ON <br />AGGREGATE <br />INS P <br />OC <br />LIMITS SHOWN MAY <br />POLICY Mumma <br />� EFFECT <br />DATEIMMIDGWY) <br />DATEIMMIPOMY) <br />LIMITS <br />11000,000 <br />L <br />MISRD <br />wepoPINSURANCE <br />/ / <br />/ / <br />EACH OCCURRENCE <br />S <br />A <br />X <br />GRNERALUABIUTY <br />D TO RENTED <br />PREMISES Ea arta/fanm <br />S 50,000 <br />j <br />X <br />COMMERCIAL GENERAL UIAbIUTY <br />10/04/2003 <br />10/04/2004 <br />MEG I" ono <br />4 5, 000 <br />CLAIMS MADE FXI OCCUR <br />2003-OASTS <br />PERSONAL S AOV INJURY <br />$ 1,D00, 000 <br />X <br />PROFESSIONAL LIAE- <br />/ / <br />/ / <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />X <br />ZMRMPSR SEXUAL CON. <br />PROPUCTS-COMP/OPAGG <br />$ 11000,000 <br />GEN'L AGGREGATE LIMIT AP%IES PER: <br />/ / <br />/ / <br />IA�BppGA SSXUT.L CON. <br />1,000,00C <br />A <br />X AWAUTO 1o/04/2 <br />ALL OWNED AUTOS 2003-04575 <br />SCMDULEDAUTO$ <br />HIREDAUTOS iC?.; r•I-, ;,,�� ..,etc 4, <br />RON-0WNED AUTOS <br />GARAGE LIABILITY <br />ANY AUTO <br />E E)ICESSIUMBRELLA Wsuiv OIRECTORS L OYFICEAS <br />10/04/: <br />OCCUR X�CWMS MADE <br />EDSINGLE LIMIT <br />ieanU <br />S 1, 00D, QQQ <br />INJURY <br />n ) <br />, <br />-_ <br />10/04/2004 <br />INJURY <br />ci ) <br />LQNLY:� <br />$ <br />RTY DAMAGE <br />nD <br />$ <br />ONLY ACCIDENT <br />$ <br />THAN EAACC <br />$ <br />S <br />ONLY: ,, �,. <br />DEDUCTIBLE <br />MILKY P T E D <br />RETENTION S <br />AND <br />SAryflON <br />UAW <br />� ICEDMAM13TER�EXCLUDeW <br />If YN, dv�Ma WNW <br />CCP0049129-02 <br />10 /04 /2003 <br />10/04 / <br />SPECIALEROVISIOMS nam <br />CTIER EMPLOYER DISRODTE9TZ <br />C <br />/ / <br />/ / <br />LIMITS <br />DESCRIPTION CP OPERA'OONSILOCATIONSAAEMCLESAEXCLUSIONS ADDED SY pROORSEMENTISPECIAL PROMSIONS <br />TEst CITY OF 3ANTA AMA, IT9' OFFSC1ALSw OE'1TICERS, AGENTS, EMPLOYEES, AND VOLUNTEERS, IS NANEP A3 <br />ADDITIONAL INSORED AS A PONPIT7G SCONCE CONCMMI=G TEE OPERATYONS F TEE INSURED UTAIER THIS AGRBENl:NT. <br />CITY OF SANTA ANA/CDHG <br />COW. DEV.AGY./L.FLORES <br />p.0. HOX 1988 M-25 <br />SANTA ANACj <br />ACORD 25 (2007708) <br />Q�TM INS025 (Dloe).o. <br />x <br />S <br />75, 0001 <br />CANCELLATION <br />647-6549 SHOULD ANY Oft THE ABOVE DESCRIGED POLICIES Be CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF• THE ISSUING INSURER WILL XI(a 1M4OX)= MAIL <br />30 DAYS WRITTEN NOTICE TO THS CERTIFICATE HOLDER NAMED TO THE LEFT. ISIYK•• <br />M�O��(m�>flfX�hK%R%X)L�1PL�N7ii(E <br />777� <br />-'-~ <br />702" ORD CORPORATION 198� <br />Papo + o: <br />ELECTRONIC LASER FORMS. INC. • ( 1.127.OsaB <br />1' 4K <br />